Impact of persistent substance misuse on 1-year outcome in first-episode psychosis

Background: Substance misuse is a common comorbid problem in people presenting with first-episode psychosis and is associated with a poor short-term outcome.

Aims: The aim of this study is to examine differences in baseline characteristics and 1-year outcome between individuals with first-episode psychosis who have never misused substances, those who stop misusing substances after initial presentation and those who persistently misuse substances over the 1-year assessment period.

Method: Patients were recruited to the Northern Ireland First Episode Psychosis Study (n=272). Clinical assessments were performed at baseline and at 1 year (n=194) and data were collected from the case notes.

Results: Individuals with persistent substance misuse had more severe depression, more positive symptoms, poorer functional outcome and greater rates of relapse at 1 year than those who stopped and those who had never misused substances. There were no differences in outcome between people who had never misused substances and those who stopped misusing after presentation.

Conclusions: These results support assertive intervention targeted at comorbid substance misuse in individuals with first-episode psychosis.

On the continuity of the support of masa-bimodules

We anounce results on the continuity of the map sending a masa-bimodule to its support. The proofs of the results will be published elsewhere.

Museums and youth: between misunderstanding and disappointment. Youth perceptions and arguments about the cultural consumption of museums in Chile

Young people are less explored in museum audience research; this is a paradoxical situation when considering its strategic location in the cultural reproduction and if considering the high performing cultural consumption compared with other sectors. The phenomenon of museums consumption by young Chileans who are self recognized as public and non-public museums is explored from a qualitative approach. It was conducted with focus groups in the three largest cities in Chile (Santiago, Valparaíso and Concepción). They identify the museum as a cultural institution in full force. However, in questioning museums activity youth reveal the specificity of their cultural matrix. This is referred to a social temporality based on the fragment, the discourse of familiarity, proximity and instead of breaking and critical. They claim a museum aesthetic / historical experience based on pleasure and enjoyment. An overview is proposed to further clarify the youth cultural consumption to characterize more precisely the place of the museum in the set, to design more effective policies museums.

Primitivismo y Feminismo en el arte contemporáneo

Para la mentalidad colonialista del siglo XIX la raza negra estaba provista de una extraordinaria sexualidad y lujuria. En la metrópolis el equivalente era la mujer sexuada, la prostituta. En los primeros años del siglo XX este tándem, prostituta-colonizado, sirve a los artistas vanguardistas como elemento de confrontación con la moral imperante. Son las artistas mujeres, con una intención feminista, quienes principalmente utilizan el primitivismo asociado a la mujer en su crítica a los estereotipos. Figura pionera en ello es Hannah Höch, especialmente en su serie De un Museo Etnográfico, en el que asocia figuras femeninas y objetos de arte primitivo. En los años 70 del siglo XX, algunas artistas de la performance, como Carolee Schneemann o Ana Mendieta reivindican el cuerpo femenino con el significado de Origen y Fertilidad que tiene en las culturas primitivas. En este mismo contexto puede inscribirse la escultura Maman de Louise Bourgeois. El elemento de crítica social, que está vigente aún en nuestros días, puede verse en las obras de las Guerrilla Girls.

Optical coherence tomography is a valuable tool in the study of the effects of microneedle geometry on skin penetration characteristics and in-skin dissolution.

In this study, we used optical coherence tomography (OCT) to extensively investigate, for the first time, the effect that microneedle (MN) geometry (MN height, and MN interspacing) and force of application have upon penetration characteristics of soluble poly(methylvinylether-co-maleic anhydride, PMVE/MA) MN arrays into neonatal porcine skin in vitro. The results from OCT investigations were then used to design optimal and suboptimal MN-based drug delivery systems and evaluate their drug delivery profiles cross full thickness and dermatomed neonatal porcine skin in vitro. It was found that increasing the force used for MN application resulted in a significant increase in the depth of penetration achieved within neonatal porcine skin. For example, MN of 600 µm height penetrated to a depth of 330 µm when inserted at a force of 4.4 N/array, while the penetration increased significantly to a depth of 520 µm, when the force of application was increased to 16.4 N/array. At an application force of 11.0 N/array it was found that, in each case, increasing MN height from 350 to 600 µm to 900 µm led to a significant increase in the depth of MN penetration achieved. Moreover, alteration of MN interspacing had no effect upon depth of penetration achieved, at a constant MN height and force of application. With respect to MN dissolution, an approximate 34% reduction in MN height occurred in the first 15 min, with only 17% of the MN height remaining after a 3-hour period. Across both skin models, there was a significantly greater cumulative amount of theophylline delivered after 24 h from an MN array of 900 µm height (292.23 ± 16.77 µg), in comparison to an MN array of 350 µm height (242.62 ± 14.81 µg) (p < 0.001). Employing full thickness skin significantly reduced drug permeation in both cases. Importantly, this study has highlighted the effect that MN geometry and application force have upon the depth of penetration into skin. While it has been shown that MN height has an important role in the extent of drug delivered across neonatal porcine skin from a soluble MN array, further studies to evaluate the full significance of MN geometry on MN mediated drug delivery are now underway. The successful use of OCT in this study could prove to be a key development for polymeric MN research, accelerating their commercial exploitation.

Inquiring into Non-Accidental Child Deaths: Reviewing the Review Process

There is significant public and professional interest in the non-accidental death of children where abuse and neglect are suspected of being contributory factors. Systems for reviewing these deaths have been developed in each of the four jurisdictions within the UK. The main aims are to ensure that individuals and professionals are held to account if practice falls below the expected standard, whilst also seeking to strengthen the systems for protecting children through reflecting on what lessons, if any, can be learnt from the death of a child through abuse or neglect. Recently, the benefit of such inquiries and the quality of serious case reviews have come under scrutiny. In this paper, the authors report the findings of a Delphi study that sought to explore how the process of conducting reviews following the death of a child could be improved through seeking the views of experienced professionals responsible for child protection in Northern Ireland. The authors conclude that the system does command professional support, but could be improved through greater attention to process issues and a stronger emphasis on translating learning into action. In common with research looking at other recent practice developments, there is a need to focus on process indicators as a means to ensuring that well intentioned policies are translated into workable and functioning practices.